December 29, 2022: As holiday celebrations conclude in the U. S. In the U. S. , COVID is on the rise, even as other people head toward what they hope will be a healthier new year.
While many would like to take a vacation even thinking about COVID, the question of what the next step with the virus is still looming. Will there be a winter wave? If so, can it be minimized?Are other mandates coming, accompanied by a return to closed offices and shops?Read on for a review of the latest news.
Cases, Hospitalizations, Deaths
As of Dec. 27, the most recent statistics, the CDC reports more than 487,000 weekly cases, up from 265,000 for the week ending Oct. 12. On average, another 4,938 people were hospitalized between Dec. 19 and Dec. 25. , 6% less than the 5,257 admitted last week.
Deaths totaled 2952 in the week of Dec. 21, up from 2699 on Dec. 14.
“What’s sobering overall is that you still see about 400 deaths per day in the United States,” says Peter Chin-Hong, MD, professor and infectious disease specialist at the University of California, San Francisco. “It’s still very high. “
Since December 17, the main variants are BQ. 1, BQ. 1. 1 and XBB. Experts said they pay special attention to XBB, which is emerging in the northeast.
Predicting an increase
Experts following the pandemic agree that there will be an increase.
“We’re in the middle of this now,” says Eric Topol, MD, founder and director of the Scripps Translational as Research Institute, La Jolla, CA, and editor-in-chief of Medscape (WebMD’s sister site). “It’s not at all like what we had at Omicron or other waves, it’s so bad, but it feels through the seniors.
Good news: “Outside of this group, it doesn’t look like the wave is as bad [as in the past],” Topol says.
Predicting the magnitude of the increase after the holidays “is the billion-dollar inquiry right now,” says Katelyn Jetelina, PhD, MPH, an epidemiologist in San Diego and the newsletter Your Local Epidemiologist.
“Many of those waves are not driven by subvariants of fear but by behavior,” she says.
People open their social networks to gather for celebrations and circle time of relatives. It’s exclusive for this winter, he thinks.
“I think our numbers will continue to increase, but not like in 2021 or 2020,” Chin-Hong said.
Others point out that the outbreak doesn’t just involve COVID.
“We’re expecting a Christmas surge and we’re convinced it’s a triple outbreak,” says William Schaffner, MD, a professor of infectious diseases at Vanderbilt University Medical Center in Nashville. It refers to the accumulation of influenza cases. and RSV (respiratory syncytial virus).
Jetelina stores this concern, fearing that these diseases are beyond hospital capacity.
With China’s easing of “zero COVID” policies, instances are emerging dramatically. Some models expect that up to 1 million COVID deaths could occur in China in 2023. (U. S. for travelers from China to provide a negative COVID check before entering. Countries such as Italy and Japan have taken action. )
“The suffering that is happening in China is not smart news at all,” Topol says. “We’re going to see him for many weeks, if not months. “
Theoretically, uncontrolled spread like the one expected can generate a new total circle of variant relatives, he says. But “the biggest blow will be in China,” he predicts. But it’s hard to assign accurately. “
“China accounts for 20% of the world’s population, so we can’t forget that,” says Jetelina. “The question is, what is the probability that a subvariant of fear will come from China?I think the probability is low, but the option is there.
What happens to cases in China may “yield a clue” in the transition from a pandemic to an endemic one, Chin-Hong says. But even if the surge in cases in China leads to a new variant, “there’s a lot of immunity to T and B cells [here], your average user may not yet get seriously ill, even if the variant looks scary. “
Minimize damage
Experts echo the same recommendation for preventing outbreak, especially for others 65 and older: Get the bivalent booster and do it now.
“The flu vaccine,” Schaffner says.
Booster and flu shots have been underutilized this year, he says. “It’s because of general vaccine fatigue. “
Low use of the booster vaccine is concerning, Topol says, especially among adults 65 and older, the age organization most vulnerable to serious illness. According to the CDC, 35. 7% of U. S. adults age 65 and older gained the booster. Topol calls it a tragedy.
The younger ones didn’t take the reminder either. Overall, only 14. 1 percent of people over the age of five received an updated booster dose, according to the CDC.
Recent studies place the price on reinforcements. One study only looked at adults 65 years and older and found that bivalent booster reduced the risk of hospitalization by 84% compared to an unvaccinated user and by 73% compared to those who won only the monovalent vaccine. Another study in adults found that those who won bivalent vaccine were less likely to need COVID-related emergency care or emergency care.
In a Dec. 21 report in the New England Journal of Medicine, researchers took plasma samples from others who gained one or two monovalent or bivalent boosters for efficacy against the circulating subvariants BA. 1, BA. 5, BA. 2. 75. 2, BQ. 1. 1 and XBB. The bivalent drove more than the monovalent against all subvariants of Omicron, but especially against BA. 2. 75. 2, BQ. 1. 1 and XBB.
Rapid tests can minimize transmission. On December 15, Biden’s management announced its winterization plan, urging Americans to conduct pre- and post-trip testing, as well as indoor visits with vulnerable individuals, providing another round of loose testing at home, proceeding to make network tests available. , and proceed to the supply of vaccines.
In addition to general precautions, Schaffner suggests, “Look at yourself. Who are you? If you’re over 65, have an underlying medical condition, are immunocompromised, or are pregnant, put your mask back on. And think about social distancing. ” Maybe it’s time to pray at home and show a movie, to go to the movies, he says.
Back to mandates?
On Dec. 9, New York City’s fitness and intellectual hygiene commissioner suggested returning to indoor mask wearing and said other people “should” wear masks, adding in schools, stores, offices and crowded environments.
On the same date, Los Angeles County Public Health called for masks to be reworn for those 2 and older when indoors, adding in schools, in transit or at structure sites when surrounded by others.
Although the CDC order requiring masks on public transport is no longer in effect, the firm continues to propose that public transport does.
But some go further. In Hiladelphia, for example, School Superintendent Tony Watlington, EdD, announced before winter break that masks will be required indoors for all students and for the first 2 weeks back to school, through Jan. 13, submitting a recommendation from the Philadelphia Department of Education. Public health.
Universal masking in schools reduces COVID transmission, as recommended by a study published in late November. After Massachusetts abandoned the state’s universal masking policy in public schools in February 2022, researchers compared the occurrence of COVID in 70 school districts there that dropped out of office with two school districts that maintained it. In the 15 weeks following the cancellation of the policy, the lifting of the order was linked to another 44. 9 COVID cases according to 1000 students and staff. This corresponded to approximately 11,901 cases and only about 30% of instances in all eastern districts within constant.
That said, experts see court orders as the exception to the rule, at least for now, generating a public backlash opposed to court orders to mask or stick to other restrictions.
“We know, it forces people to be arrested,” Topol says. “It’s not enforced. If you have a very strong recommendation, you’re probably as smart as what you’re going to do now.
There could be communities where mandates pass better than others, Schaffner says, or communities where other people take it for granted with their public health authorities.
Ring in 2023
On the way to a New Year’s rally? Before celebrations, especially those that take place indoors, “there are floor rules before a meeting, like asking visitors to be vaccinated,” Schaffner says.
Hosts can also ask visitors to check in before the event. While those are wonderful suggestions, Schaffner says he doesn’t think the vast majority of people follow this advice.
“In the ideal scenario, other people would be checked immediately within hours of the meeting,” Topol, mentioning a small chance that they only have COVID after a negative test and are not yet showing symptoms. At the meeting, get air filtration with HEPA cleaning and smart ventilation if possible, she says.
“Think about the maximum threat from the user at the event,” Jetelina says, and plan precautions around those people.
Glimmers of hope
Despite the uncertainties, experts have also presented a not-so-bleak outlook.
“I think our numbers will continue to increase, but not like in 2021 or 2020,” Chin-Hong said.
Even the risk of a surge absolutely weighs heavily on celebrations, Schaffner says.
“I inspire other people to have fun, but to do it with caution and not carelessness,” he says.
SOURCES:
Peter Chin-Hong, MD, Professor of Medicine and Infectious Disease Specialist, University of California, San Francisco.
Katelyn Jetelina, PhD, MPH, San Diego epidemiologist; editor, his epidemiologist.
William Schaffner, MD, Professor of Infectious Diseases, Vanderbilt University Medical Center, Nashville.
Eric Topol, MD, Founder and Director, Scripps Translational Research Institute, La Jolla, California, Editor-in-Chief, Medscape.
CDC: “Mask Use and Public Transportation. “
School District of Philadelphia: “A Christmas Message from Dr. Watlington. “
White House: “Biden Management Announces COVID-19 Winter Preparedness Plan. “
Notice: New York City Commissioner of Health and Mental Health.
The New England Journal of Medicine: “Eliminating Universal Masking in Schools: Incidence of Covid-19 Among Students and Staff. “
Morbidity and Mortality Weekly Report (MMWR): “Initial estimates of bivalent mRNA vaccine efficacy in preventing emergency or urgent care department encounters associated with COVID-19 and hospitalizations among immunocompetent adults: VISION network, nine states, September-November 2022. “
Morbidity and Mortality Weekly Report (MMWR): “Initial estimates of bivalent mRNA vaccine efficacy in preventing hospitalization associated with COVID-19 among immunocompetent adults aged ≥65 years: IVY network, 18 states, September 8 to November 30, 2022. “
The New England Journal of Medicine: “Neutralization BA. 2. 75. 2, BQ. 1. 1, and XBB of bivalent reinforcement mRNA. “
Institute of Health Metrics and Evaluation: “COVID-19 Projections”.
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